Ukrainian President Volodymyr Zelenskiy signed into law a bill legalising the medical use of cannabis, a parliamentary database showed on Thursday.More than 6 million people, including cancer patients, civilians with post-traumatic stress disorder, and wounded soldiers need medicine containing cannabis, according to a lawmaker.The bill signed by Zelenskiy on Tuesday would only come into force six months after it is officially published, and the ban on selling or supplying cannabis for recreational use would remain in effect.

Ukraine legalises cannabis for medical use

The Government of Saint Lucia, through the Ministry of Commerce, Manufacturing, Business Development, Cooperatives and Consumer Affairs, has been engaged in the revision and development of policy, legislation and a regulatory framework for cannabis in Saint Lucia.

In keeping with these advancements, the Government of Saint Lucia will be hosting a two-day Cannabis Symposium from March 19 – March 20, 2024 as an open-ended regional policy discussion on matters relating to cannabis.

This symposium will afford relevant stakeholders and Cannabis Authorities within the region an opportunity to hold candid discussions on some of the issues and challenges experienced throughout the region.

Subsequently, a Memorandum of Understanding (MOU) will be signed by the aforementioned parties, guided by a common interest to establish and maintain robust, inclusive and safe regimes surrounding cannabis cultivation, manufacturing, sale and use in the individual states of the region.

This MOU will, in effect, establish the Caribbean Cannabis Forum—a mechanism to encourage and host joint discussions on national, regional or international cannabis matters of relevance to the Caribbean region.

Saint Lucia to host Caribbean Cannabis Symposium

OAT reduces many of the harms associated with opioid dependence in the context of criminalisation. Improving OAT coverage globally will significantly affect morbidity and mortality outcomes for people who use drugs. Although there is a gradual increase in harm reduction intervention coverage globally, coverage and scale of interventions, such as OAT, is limited.

The meeting provided a forum for discussing increasing country-level and individual OAT access. By discussing delivery models, treatment modalities, developments in OAT options, and the necessary frameworks for structuring OAT implementation and scale-up, the meeting aimed to:

Promote introduction of OAT in countries yet to provide

Promote scale up of OAT in countries not reaching targets for level of provision

Promote tailored OAT delivery models that are locally relevant and responsive to clients’ needs

Increasing opioid agonist treatment (OAT) coverage globally

Japan has passed a bill to legalize cannabis-based medicines in a landmark revision of its stringent drug laws, while toughening its ban on recreational use of marijuana. This is a win for patient groups that have campaigned for access to these medicines.

However the changes amount to a tightening of Japan's already tough cannabis policy. Marijuana consumption was criminalized, closing a loophole that officials partly blame for a recent rise in cannabis-related arrests. Prior to the revisions, inhaling marijuana had been technically legal, as opposed to a jail term of up to five years for possession. Under the revised laws, those caught using or possessing marijuana can face a prison sentence of up to seven years.

Still, decades of a strident government crusade against illegal drugs, synonymous with the mantra of "dame zettai" (absolutely not), have led to marijuana being heavily stigmatized in Japan. Just 1.4 percent of people in Japan say they have tried marijuana, compared to more than 40 percent in France and around half in the United States, data compiled by the health ministry show.

Japan's tough anti-cannabis laws have ensnared international stars including Beatle Paul McCartney, who spent nine days in detention in 1980 after the drug was found in his baggage.

Japan to legalize cannabis-based medicines

There has been a growing concern about the misuse of pharmaceutical opioids in Africa, with some commentators describing it as part of a “global opioid crisis” (e.g. Kurth et al., 2018), ignoring the socio-historical peculiarities and contextually distinct materializations of these public health crises. Scholars have challenged this broad-brush approach through critical commentaries and original research (Klein et al., 2020; Klantschnig and Dele-Adedeji, 2021). Others have argued that conflating these distinct crises “blocks the path to rational regulatory reforms and public health strategies that could constructively address each crisis on its own terms” (Pettus and Radbruch, 2023, p. 2). A notable outcome of the global crisis narrative, according to Klantschnig and Dele-Adedeji (2021), and crucially for the purpose of this Special Issue, is the increased focus on the tramadol economy in Africa. The narrative has stirred political interests and enforcement-based responses across the continent and among international drug control agencies, who view the crisis as a “drugs” problem that should be addressed with law enforcement and bureaucratic controls (Klein et al., 2020). However, the wider social and structural drivers of opioids consumption on the continent are neglected, and the potential impacts of restrictive controls on health care remain poorly understood. This Special Issue aims to fill these knowledge gaps.

Tinasti and Outleb analyse opioid regulation in Morocco, showing how recent restrictive regulations are influenced by international frameworks and how they affect access to opioid analgesics for pain management and palliative care, as well as opioid agonist therapy. Ane-Loglo examines tramadol regulation in Ghana and six other African countries, showing how they impact the medical use of tramadol. Although tramadol is essential for managing pain in these countries, existing regulatory frameworks hinder access to these medicines. Onyima documents how street-involved young men in a south-eastern Nigerian city obtain opioids from street drug dealers and pharmacies and consume them by sniffing, popping and mixing tramadol with other drugs. These practices emerged in response to the threat of formal control. Nwafor and colleagues show how manual labourers in two south-eastern Nigerian cities consume tramadol to improve energy for work, pain relief and sexual performance. These consumption practices are contextualized by difficult working conditions and low access to pain management. Nelson and colleagues show how strict measures imposed by the Nigerian state on opioid supply due to public concerns about non-medical use among youth did not mitigate this practice. Instead, it constrains access to opioids for medical purposes and fuel police corruption. Dele-Adedeji and colleagues show how social relationships facilitate the illegal tramadol market in Nigeria, enabling market actors to resolve frictions between illegality and the social acceptability of tramadol. Last, but not the least, Otu and colleagues describe how domestic and international politics shape opioid control in Nigeria, reproducing punitive approaches that hinder access to opioids for medical purposes.

An overview of legal and policy barriers to opioid analgesics access and opioid agonist therapy in Morocco

Tramadol control measures and supply for health-care services: findings from Ghana and other West African countries

Prescription opioids, consumption cultures and “informal governing images” among “young street guys” in Nigeria

“It worked for my friend”: non-medical use of tramadol among manual labourers in Anambra state, Nigeria


Chidozie Edwin Nwafor, Chukwuemeka Felix A. Okoye, Nelson I. Nwankwo, Paschal Chukwuma Ugwu

Tramadol regulation, illegal markets and consumption practices: exploring frictions of drug control in Nigeria


Ediomo-Ubong Nelson, Ogochukwu Winifred Odeigah, Emeka W. Dumbili

Resolving friction in the tramadol economy in Nigeria


Ini Dele-Adedeji, Lala Ireland, Gernot Klantschnig

Beyond evidence and reality: the politics, political economy and fallout of hawkish regulatory policy on prescription drugs in Nigeria


Smart E. Otu, Macpherson Uchenna Nnam, Mary Juachi Eteng, Ijeoma Mercy Amugo, Babatunde Michel Idowu

Drinking to cope and college grade point average


Morgan A. Douglass, Madison L. Colley, Alexander J. Tyskiewicz, Mark A. Prince

Ayahuasca ceremonies: set and setting features across Italy and Colombia


Federica Ambrosini, Laura Pariset, Roberta Biolcati

Family ties: examining family functioning and alcohol use among American Indian youth


Morgan A. Douglass, Meghan A. Crabtree, Linda R. Stanley, Randall C. Swaim, Mark A. Prince

Frictions in drug control: prescription opioids, prohibition and consumption cultures in Africa

 Thursday, 30 November 2023 / 15:00 - 16:30 (GMT - London)

This recording is available in English and 

Global Coalition to Address Synthetic Drugs Threats

 with the objective of mobilising the international community to “come together to collectively combat this shared challenge”. By October 2023, some 120 governments had signed up to be part of the Coalition.

In parallel, the USA will table a resolution at the 78th Session of the UN General Assembly that calls on UN Member States to prioritise global action to address the public health and security challenges posed by synthetic drugs.

Nonetheless, the question remains as to whether the Global Coalition will seek to promote innovative approaches to synthetic drugs, that are grounded in health and human rights, or whether it will be yet another vehicle to continue promoting interdiction and eradication.

This online event aims to inform and feed into this discussion, with inputs from health and human rights experts. Speakers will discuss a breadth of issues which include:

How prohibition itself has fuelled the increase in the diversity and use of synthetic substances (the so-called balloon effect) and the flaws this exposes in international drug control.

The medical significance of synthetic drugs like tramadol and ketamine in many parts of the world and how international scheduling would drastically reduce their availability.

The importance of harm reduction as the foremost pillar in the response to all drug use, including synthetic drugs, especially as it relates to preventing and responding to overdoses - as well as measures aimed at ending sanctions and reducing stigma against people who use drugs.

A discussion of the potential offered by the Global Coalition and its resolution to directly and progressively address these issues.

Keynote: Professor Adeeba Kamarulzaman, Global Commission on Drug Policy

Daan van der Gouwe, Drug Markets Researcher, Trimbos Instituut, Netherlands

Theshia Naidoo, Managing Director of U.S. Foreign Policy, Drug Policy Alliance, USA

Andrzej Celinski, Contract Manager & Executive Administrator, Canadian Association of People who Use Drugs

Lisa Sánchez, Executive Director, Mexico Unido Contra la Delincuencia

Smriti Rana, Head of Strategic Programs and Partnerships, Pallium India 

Moderated by Ann Fordham, International Drug Policy Consortium.

Synthetic realities: Global drug policies beyond the 'new threat' narrative

For the first time since its conception, this year the World Drug Report consists of two products, a web-based element and a set of booklets. The latest global, regional and subregional estimates of and trends in drug demand and supply are presented in a user-friendly, interactive 

 include key takeaways and policy implications, 

 takes the form of an executive summary based on analysis of the key findings of the online segment and the thematic

 and the conclusions that can be drawn from them. In addition to providing an in-depth analysis of key developments and emerging trends in selected drug markets, including in countries currently experiencing conflict, booklet 2 focuses on a number of other contemporary issues related to drugs.

World Drug Report 2023

Mexico’s president has been the first North American leader 

 the outright ban of the medical use of fentanyl, as relationships between his country and its northern neighbour sour through the handling of the overdose crisis.

The traffic of fentanyl from Mexico across to the US has strained relationships between both countries: Mexican President Andrés Manuel López Obrador has 

 in the past that his government is doing more to control the drug than their northern neighbours, and that the American overdose crisis is more related to the decay of family and moral values than about the drugs.

Fentanyl in North America is the iron law of prohibition in action

While concerns with drug deaths involving fentanyl are important to highlight, banning their use from medical contexts will do nothing to stem deaths. This is primarily because fentanyl is 

 the heroin (and increasingly other substances’) supply. As a 

, small quantities of it can be mixed into -or entirely replace – many drugs to potentiate their effects. However, this can have deadly effects as consumers are not aware that this is going on unless they 

. Since its introduction into the North American heroin and benzodiazepine drug supply (which happened as early as

, fentanyl has come to dominate drug markets.

Fentanyl’s infiltration of the North American market is an example of the iron law of prohibition 

 of opioid medication like OxyContin to North American patients, as well as lax regulation on prescribing, created a massive demand for this class of drugs. After the American Centre for Disease Control and Prevention 

 of opioids in 2016, cracking down on pill mills and excessive prescribing, the disappearance of a safe supply of this drug alongside massive demand created the perfect conditions for a potent, easily imported and manufactured substitute to appear.

Mexico's threat to ban medical fentanyl is painfully misguided

The Seventy-sixth World Health Assembly is being held in Geneva, Switzerland, on 21–30 May 2023.

. Simultaneous interpretation is available in Arabic, Chinese, English, French, Russian and Spanish.

Inter-ministerial dialogue: 'Essential medicines under international control: ensuring equitable and affordable access to and safe use for all'

Tuesday, 23 May | 13:00 - 14:00 | Hotel President Wilson, 47 Quai Wilson, Geneva 

To join in person or online, please RSVP 

by 22 May to Tamara Garcia (tamara.garcia[@]globalcommissionondrugs.org) specifying whether you will be attending in-person or online.

Co-organised by the Global Commission on Drug Policy (GCDP) and the World Health Organization (WHO)

The goal of this Ministerial Dialogue is to provide a space where member States (in this case, Ministries of Health) can present and discuss progress and shortfalls in their national policies, while providing examples and noting promising practices in the field of access to and safe use of essential medicines under international control. The dialogue will also provide a means to check in on global progress and problems, while at the same time aiming to identify and discuss concrete collaborative solutions.

Responding to the global crisis of overdose

Friday, 26 May | 11:00 - 13:00 (CEST) | Hybrid event | UNAIDS Secretariat 20, Avenue Appia CH-1211 Geneva 27 Switzerland in the Kofi Annan Room

Responding to the Global Crisis of Overdose

 Please RSVP to giavana.margo[@]opensocietyfoundations.org to receive a Zoom link

Co-organised by the Open Society Foundations and UNAIDS

Opioid overdose, already a major cause of mortality in many countries, is increasing alarmingly across the world. A key factor in death rates everywhere is the presence of fentanyl and other strong synthetic opioids in the illicit drug supply, coupled with increasing availability and decreasing costs for all drugs. Globally, overdose mortality data is often incomplete and does not tell the whole story. However, many signs suggest this crisis will expand across the world in the coming years.

Overdose mortality has long term global, economic, social, cultural, and political implications – like AIDS – and similar global health leadership is needed in framing the response. Most opiate overdose deaths are easily avoidable with the right intervention, and there much evidence to support known interventions. We need the political will to bring these solutions to scale.

This event brings together an expert panel to review global trends on overdose and to discuss what progress has been made in the past decade on overdose intervention and response. It will provide a forum to discuss progress and challenges within national policies, while learning from innovative interventions from multiple countries.

76th World Health Assembly

Accra, Ghana, was recently host to a visionary conference on the future of cannabis in the country. The event, organised by 

the International Drug Policy Consortium,

, brought together over 50 participants from the drug policy reform and economic justice sectors, policymakers and cannabis farmers across Ghana.

The two-day conference on 25 - 26 April titled “

An Equitable Roadmap for the Legal Regulation of Cannabis in Ghana that Protects Livelihoods and Supports Sustainable Development

” sought to explore drug policy reform beyond the Narcotics Act 1019 (2020) and look towards establishing a shared, equitable vision for the legal regulation of medical and adult-use cannabis.

Three key areas were addressed: the historical and current harms caused by prohibition; the significant risks of international corporate capture of future legal trade; and, the opportunities of legal regulation to prioritise social and economic justice and achieve a sustainable transition for those working in the trade.

Through participatory and cross-sector workshops, participants were invited to envision models of legal regulation for industrial hemp, medical and adult-use cannabis using 

Health Poverty Action’s Social Justice Lens

. The models of regulation developed sought to address the harms of prohibition and strengthen a wide range of social justice areas, such as governance, public health, environmental protection and human rights.

The models of regulation developed sought to address the harms of prohibition and strengthen a wide range of social justice areas, such as governance, public health, environmental protection and human rights.

This process culminated in a draft vision presented to policymakers on day two. The vision highlighted some clear shared goals, notably in relation to gender equality, avoiding corporate capture and progressive taxation. Participants strongly highlighted the gender dimension, with farmers proposing that the market regulations adopt a gender-sensitive approach to address the issues of disproportionate harm and exclusion experienced by women under prohibition, as well as the lack of comprehensive childcare for agricultural workers. Many suggested that the revenues raised from taxes from the new cannabis market should support the provision of childcare, removing barriers in women's access to stable livelihoods in farming.

They also called for the legal market to be equitably taxed, and for measures to be implemented to impede the diversion of fiscal revenue into tax havens. In the same vein, participants called for the reinvestment of taxation into serving national and community needs, particularly public health and harm reduction programmes.

Participants learnt about a range of legal regulatory models being used around the world, all with particular priorities and unique results. Dasheeda Dawson

Founding Director of Cannabis NYC, delivered a special report on day two, inspiring stakeholders with the community-led campaign for social and restorative justice at the heart of New York's cannabis reforms.

The meeting was the first of its kind in West Africa to bring together the expertise and knowledge of Ghanaian trade unionists and economic justice experts with the drug policy community. Participants learnt about other trades in Ghana, such as cashew, biofuel and cocoa, that have all been captured by oppressive and harmful tactics of exploitation from international foreign corporations. A key question voiced loud and clear was whether Ghana would continue its colonial mandate and legacy of producing raw materials for the metropole or could cannabis rewrite the textbook?

A key question voiced loud and clear was whether Ghana would continue its colonial mandate and legacy of producing raw materials for the metropole or could cannabis rewrite the textbook?

To ensure that economic justice is at the heart of any new legal framework for cannabis, measures must be put in place to prevent commercialisation and corporate monopolisation. Our economic justice colleagues urged farmers and civil society to organise themselves into associations and trade unions. Whether these unions should be specific to cannabis or join existing agricultural unions was a critical question to be given further attention. There was strong support for stakeholders to be better equipped with knowledge on how corporations behave and a commitment to continue working on a shared vision of future markets through more intersectoral meetings. After a comprehensive presentation on 

 from Steve Rolles, Senior Policy Analyst from 

 participants explored what cannabis corporation ‘takeovers’ might look like and what to anticipate and avoid.

Working on a shared vision helped farmers and civil society to identify risks that regulation might bring about. These were mainly the possibility of new markets facilitating land grabbing and eroding food security for the poorest communities. With an incoming climate crisis farmers agreed that Ghana must not find itself in a situation of planting more cannabis than food, and that sustainable farming methods and environmental safeguards must be prioritised in regulation.

Farmers felt that to ensure local farmers' participation, there is a need for transparency and accountability from the start by considering the inclusion of local content and standardisation in the certification process as it develops, not after. Most farmers believed it is critical to prevent the emergence of foreign or domestic corporate monopolies and use licensing to ensure the market prioritises small and medium-sized businesses.

Feedback from policymakers indicated that the workshop was timely and valuable, Many noted it was a relief to discuss the impacts of cannabis regulation from so many viewpoints and intersections in a non-judgemental space. This allowed everyone to approach the subject through common sense and logical perspective rather than from their specific area of expertise.

Almost all participants concluded that drug policy reform in Ghana must be addressed through multi-sector meetings like these, which allow for a diverse conversation. There was a strong consensus that prohibition was harming communities and an emphasis on seeking ways to avoid repeating the mistakes of other trades that have prioritised big business over people.

There was a strong consensus that prohibition was harming communities and an emphasis on seeking ways to avoid repeating the mistakes of other trades that have prioritised big business over people.

 in Ghana and paved the way for a multi-stakeholder journey towards legal regulation that protects livelihoods and supports sustainable development.

The meeting was made possible with financial support from Health Poverty Action.

Envisioning equitable cannabis reform in Ghana 

Cannabis has a long history of medical use that spans back thousands of years. The first recorded medical use for the plant dates back to 2737 BC, in the world’s oldest pharmacopeia where cannabis was indicated for over a hundred ailments including gout and malaria.

Across time and space, various cultures, including the local one, have grown the plant and utilized it spiritually, culturally, industrially as well as medicinally. Scholars have studied and recorded its medical properties and benefits through the ages until the 20th century when the international drug control regime strictly restricted its use, scheduling it under both Schedule I of the 1961 and 1971 conventions and Schedule IV of the 1961 convention. Schedule IV of the 1961 Convention contains “the most dangerous substances which are particularly harmful and of extremely limited medical or therapeutic value”. Schedule I of the 1971 convention contains, for its part, the substances “presenting a high risk of abuse, posing a particularly, serious threat to public health which are of very little or no therapeutic value.”

As such, the drug conventions effectively halted any research into cannabis, until a recently renewed interest emerged worldwide with a number of research institutions focusing on the properties of the plant, and experimenting with different legal frameworks for the control, regulation or legalization of controlled substances. 

In 2018, the World Health organization’s Expert Committee on Drug Dependence (ECDD) recommended rescheduling cannabis to recognize its medicinal properties and medical uses, allowing for a more flexible approach towards the use and research of cannabis. In December 2020, the Committee on Narcotic Drugs (CND) partially took into consideration the ECDD’s recommendation and removed cannabis from Schedule IV of the 1961 Convention while keeping THC under Schedule I of the 1961 Convention.

In the meantime, after years of regional instability and faced with the growing threat of economic and financial collapse, Lebanon was looking at avenues for possible economic growth and financial gains. Enter the 2018 Mc Kinsey report, proposing around 150 economic options for Lebanon’s economy, including the export of cannabis which promised returns of $1 Billion. 

In April 2020, the Lebanese parliament passed a law legalizing “the Cultivation of Cannabis for medicinal and industrial purposes.” Law 178/2021 establishes two bodies in charge of granting licenses to persons or entities for the cultivation of cannabis and defines the requirements to apply for a permit, cultivate cannabis and sell it or manufacture products from the plant. 

In the section detailing the rationale for the law, Lebanese legislators highlight the “scientific findings and the many studies pertaining to the medicinal benefits of cannabis”, all the while denying the rights of local population and residents to access medicinal cannabis. 

Since the days of the French mandate in Lebanon, the state has adopted a repressive approach to drugs and has considered cannabis an illicit substance despite the long history of cultivation of the plant in the country. In 1998, Lebanon passed law 673/1998 which criminalizes the use of illicit drugs and schedules cannabis as a “very dangerous substance with no medical use3”. 

Despite legalizing the cultivation of cannabis for medical purposes and recognizing the plant’s medicinal properties, the 2020 law fails to expressly provide the right to consume medicinal cannabis, fails in amending the Lebanese Law on Drugs which criminalizes substance use and personal possession, and fails to reschedule cannabis as a substance with medicinal properties. 

By failing to consider avenues through which the local population could benefit from the scientific and medical advances linked to cannabis, it emerges that the Lebanese legislator has solely focused on the economic prospects all the while avoiding reconsidering its drug policies. It has done so, as evidenced by the raison d’etre of the law, to “protect public health” and shield it from the “health risks linked to the use of cannabis.” Whereas the medical use of other substances that are considered “dangerous and harmful” is still allowed under certain conditions.

Should the state focus only on the legality of a substance, upholding its moralistic view of cannabis while disregarding the medical evidence that would benefit the individual’s health?

In light of these contradictions, Skoun interviewed health care professionals in Lebanon as well as patients and academics to establish the need to amend drug laws in Lebanon in order to ensure access to medicinal cannabis to people residing in Lebanon. 

This policy paper will look at the history of cannabis in Lebanon and the attempts to control its cultivation, the specificities of Lebanese cannabis, the right to access medicinal cannabis through the right to health lens, the right to access medicinal cannabis in light of the SDGs, and finally explore legal avenues to ensure access to medical cannabis. 

Before tackling access to medical cannabis, this paper will briefly go over the law regulating cultivation of medicinal cannabis and some of its most prominent failures that go beyond the absence of recognition of the right of people to access medical cannabis for medical purposes.

The legalization of the cultivation of cannabis in Lebanon - Moralistic views vs the right to health

The sale of nitrous oxide, or laughing gas, to the public will be banned and the police will be given enhanced drug-testing powers as part of Rishi Sunak’s attempt to crack down on antisocial behaviour “with urgency”.

The levelling up secretary, Michael Gove, 

 the proposals would stop parks being turned into drug-taking arenas, and would help ministers stamp out antisocial behaviour.

The ban comes a month after the independent Advisory Council on the Misuse of Drugs (ACMD) 

 and said it would be disproportionate with the level of harm associated with nitrous oxide. It said such control could create “significant burdens” for legitimate uses of the substance.

Experts have criticised the “same old tired drug policy” from the Conservatives, insisting the ban will not stop young people from using it.

Access to controlled medicines